Evaluation of the Effectiveness of a Personalized Music-Based Aerobic Exercise Rehabilitation Program for Patients With Subacute Stroke

Subacute stroke represents a critical window for neurological recovery, during which neuroplasticity is heightened and rehabilitation interventions may have a stronger impact on long-term functional outcomes. Despite receiving standard inpatient rehabilitation, many patients continue to experience persistent limitations in mobility, balance, and emotional well-being. There is growing evidence that aerobic exercise can enhance neuroplasticity, improve cardiovascular fitness, and support motor relearning during stroke recovery. Music-based rehabilitation approaches, including rhythmic auditory stimulation, have also been shown to facilitate coordinated movement, increase engagement, and positively influence mood.

However, most aerobic exercise protocols studied internationally-such as treadmill walking, stationary cycling, or moderate-to-high intensity regimens-are not feasible for many patients in the subacute phase because of weakness, impaired balance, or restricted mobility. There is a need for accessible, adaptable, and lower-intensity aerobic interventions that can be delivered safely during inpatient rehabilitation without requiring specialized equipment.

This study was designed to address this gap by developing a structured music-based aerobic exercise program tailored to the physical capacity of individuals with subacute stroke. The intervention incorporates rhythmic music with clear tempo cues to support timing, pacing, and coordination of limb and trunk movements. The exercise sequence includes warm-up, rhythmic aerobic movements, and cool-down, and may be performed in either a seated or supported standing position depending on each participant's functional ability. Music selections are chosen to provide stable rhythm, moderate tempo, and a motivating emotional tone, which may enhance participation and therapeutic engagement.

The trial uses a randomized controlled design to investigate whether adding this structured music-based aerobic program to standard inpatient rehabilitation produces additional improvements over a 6-week period. The conceptual foundation for this intervention draws from principles of neurologic music therapy, aerobic conditioning guidelines for individuals post-stroke, and emerging evidence that music can improve movement synchronization, attentional focus, and emotional regulation.

Safety is an integral component of the study design. The intervention was created specifically to avoid complex or destabilizing movements and to remain within a mild-to-moderate intensity range appropriate for subacute stroke patients. Continuous supervision by rehabilitation therapists and monitoring of vital signs aim to ensure that the program remains safe and well tolerated. The study also includes procedures for identifying, documenting, and managing adverse events and for adjusting the protocol as necessary to maintain participant safety.